Case 146

Abstract

HomeRadiologyVol. 250, No. 2 PreviousNext Diagnosis PleaseFree AccessCase 146Phillip J. Koo, John S. WillsPhillip J. Koo, John S. WillsAuthor Affiliations1From the Department of Radiology, Pennsylvania Hospital, University of Pennsylvania Health System, 800 Spruce St, Philadelphia, PA 19107. Received July 13, 2007; revision requested September 10; revision received October 8; accepted December 17; final version accepted February 19, 2008.Address correspondence to P.J.K. (e-mail: [email protected]).Phillip J. KooJohn S. WillsPublished Online:Feb 1 2009https://doi.org/10.1148/radiol.2502071233MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked InEmail HISTORYA 27-year-old gravida 1, para 1 woman who had a history of pelvic inflammatory disease presented to the emergency department with lower abdominal pain, nausea, vomiting, and chills. She began menstruating the night before presentation and reported an acute exacerbation of her chronic abdominal pain, which typically worsened with her menses. Her surgical history included one caesarean section and laparoscopic excision of a tubo-ovarian abscess. She was afebrile. Physical examination revealed mild diffuse abdominal tenderness and tenderness of the cervix. Laboratory findings revealed a white blood cell count of 17 000 cells per cubic millimeter. (A normal white blood cell count is between 4800 and 11 000 cells per cubic millimeter.)Ultrasonography (US) of the pelvis was performed (,Figs 1, ,2). A computed tomographic (CT) examination of the abdomen and pelvis was subsequently performed after intravenous administration of 125 mL of iohexol (Omnipaque; Amersham Health, Princeton, NJ). We acquired 5-mm axial sections and performed 3-mm coronal reconstruction (,Figs 3, ,4).Submit the most likely diagnosis to http://rsna.org/dxplease (use only for submission of diagnosis). Select the case from the Active Case List for which you are submitting a diagnosis. Only one case, one name, and one diagnosis per e-mail submission. Multiple diagnoses and multiple submissions will not be considered. Deadline: Midnight U.S. Central Time, April 10, 2009. Answer will appear in the June issue. Authors wishing to submit cases for Diagnosis Please should first write to the Editor to obtain approval for the case and further information.Figure 1: Sagittal transabdominal US image of the left adnexa.Figure 1:Download as PowerPointOpen in Image Viewer Figure 2: Axial transabdominal Doppler US image of the right lower quadrant of the abdomen.Figure 2:Download as PowerPointOpen in Image Viewer Figure 3: Oral (20 mL iohexol diluted with 430 mL of water) and intravenous contrast material–enhanced axial CT image of the pelvis.Figure 3:Download as PowerPointOpen in Image Viewer Figure 4: Oral and intravenous contrast-enhanced coronal CT image of the abdomen and pelvis.Figure 4:Download as PowerPointOpen in Image Viewer Authors stated no financial relationship to disclose.Article HistoryPublished in print: 2009 FiguresReferencesRelatedDetailsRecommended Articles Pelvic Inflammatory Disease: Multimodality Imaging Approach with Clinical-Pathologic CorrelationRadioGraphics2016Volume: 36Issue: 5pp. 1579-1596Case 268Radiology2019Volume: 291Issue: 1pp. 259-260Imaging of Peritoneal Dialysis Complications in ChildrenRadioGraphics2022Volume: 42Issue: 2pp. 559-578Interventional Radiology Placement and Management of Tunneled Peritoneal Dialysis Catheters: A Pictorial ReviewRadioGraphics2020Volume: 40Issue: 6pp. 1789-1806Imaging Evaluation of Fallopian Tubes and Related Disease: A Primer for RadiologistsRadioGraphics2020Volume: 40Issue: 5pp. 1473-1501See More RSNA Education Exhibits Pelvic Inflammatory Disease: Essentials of ImagingDigital Posters2018Danger in the Pelvis!!: A Case-based Review of Female Pelvic Emergencies on MDCTDigital Posters2020A Trainee’s Guide to Ovarian Emergencies in the EDDigital Posters2018 RSNA Case Collection Early pelvic inflammatory diseaseRSNA Case Collection2020Meckel's diverticulitisRSNA Case Collection2021Fitz-Hugh-Curtis syndromeRSNA Case Collection2021 Vol. 250, No. 2 Metrics Downloaded 323 times Altmetric Score